The Use of Low Molecular Weight Heparins for Post-Surgical Deep Vein Thrombosis Prevention in Orthopaedic Patients

1988 ◽  
Vol 16 (5) ◽  
pp. 359-366 ◽  
Author(s):  
E. Chiapuzzo ◽  
G. B. Orengo ◽  
G. Ottria ◽  
A. Chiapuzzo ◽  
E. Palazzini ◽  
...  

The prophylactic antithrombotic efficacy of a low molecular weight heparin was compared with a traditional unfractionated calcium heparin after orthopaedic surgery in 140 patients. Deep vein thromboses were detected in legs either by Doppler sonography or [125I]fibrinogen uptake tests in five (7.1%) and seven (10%) patients, respectively. The capacity of both drugs to prevent deep vein thrombosis was demonstrated. Compared with the control group, those who used low molecular weight heparin showed a significant increase of activated factor X inhibition and smaller increases in activated partial thromboplastin times. Tolerability of both drugs was good, with a low incidence of local side-effects.

2015 ◽  
Vol 18 (6) ◽  
pp. 222 ◽  
Author(s):  
Mehmet Ezelsoy ◽  
Gorkem Turunc ◽  
Muhammed Bayram

<strong>Background:</strong> Acute lower extremity deep vein thrombosis (DVT) occurs due to obstruction of large veins by thrombus and its clinical findings are pain and swelling. If not treated, it can cause morbidity and mortality. Oral warfarin or low molecular weight heparin are applied in traditional treatment. However, recently, endovascular procedures have gained increasing popularity in deep vein thrombosis. In this study we aimed to compare our early results of pharmacomechanical thrombectomy (PMT) versus oral anticoagulation for acute deep vein thrombosis. <br /><strong>Methods:</strong> We comprised 50 patients presented with acute DVT between January 2013 and June 2014, who received either adjusted subcutaneous low molecular weight heparin (LMWH) or PMT followed by intravenous unfractionated heparin (UFH) for 5 days. Warfarin was administered to PMT patients for 3 months and at least 6 months for the control group. <br /><strong>Results:</strong> Median follow-up was 14 months (6-18 months). Recanalization within 6 months was found in 84.0%, femoral venous insufficiency was found in 36.0%, and postthrombotic syndrome (PTS) was found in 28.0% of the patients who received PMT treatment. The mean duration of symptoms was 11.0 days (range, 3-20 days). The mean duration of the procedure was 78.1 minutes (range, 55-100 min).<br /><strong>Conclusion:</strong> In contrast to medical therapy in the treatment of deep vein thrombosis, usage of catheter-directed thrombolysis experienced early recanalization with higher thrombus resolution. PMT with adjunctive thrombolytic therapy is an effective treatment modality in patients with significant DVT. Also, early thrombus removal in patients with acute DVT prevents development of postthrombotic morbidity. We believe that the efficacy and usage will increase with the experience of surgeons in the future.


1998 ◽  
Vol 79 (05) ◽  
pp. 897-901 ◽  
Author(s):  
Bernard A. Charbonnier ◽  
Jean-Noël Fiessinger ◽  
J. D. Banga ◽  
Ernst Wenzel ◽  
Pascal d’Azemar ◽  
...  

SummaryBackground: Clinical trials have been performed to compare with standard heparin a once or a twice daily regimen of low-molecular-weight heparin but no direct comparison has been done between these two low-molecular-weight heparin regimens in terms of efficacy and safety with a long-term clinical evaluation.Methods: Patients with proximal deep vein thrombosis, confirmed by venography were randomly assigned to either nadroparin (10,250 AXa IU/ml) twice daily or nadroparin (20,500 AXa IU/ml) once daily for at least 5 days. Regimens were adjusted to bodyweight. Oral anticoagulants were started on day 1 or 2 and continued for 3 months. Patients were followed up for 3 months. The composite outcome of venous thromboembolism and death possibly related to pulmonary embolism was the primary measure of efficacy. Major bleeding was the principal measure of safety. The study was designed to show equivalence between the two regimens.Results: Recurrent thromboembolic events or death possibly related to pulmonary embolism were reported in 13 patients in the once daily group (4.1%) and in 24 patients of the twice daily group (7.2%): (absolute difference 3.1% in favor of the once daily regimen; 95% confidence interval -6.6%, +0.5%). Major bleeding episodes during nadroparin treatment occurred in 4 (1.3%) and 4 patients (1.2%) in the once and twice daily groups, respectively.Conclusions: A nadroparin regimen of one injection per day is at least as effective and safe as the same total daily dose divided over two injections for the treatment of acute deep vein thrombosis.


2019 ◽  
Vol 25 ◽  
pp. 107602961989041
Author(s):  
Chu Chen ◽  
Qing Tang ◽  
Wenjuan Zhang ◽  
Huijun Yuan ◽  
Ying Huai ◽  
...  

At present, there is no consistent understanding of the effect of traditional Chinese medicine (TCM) prescription in the prevention of the deep vein thrombosis (DVT), though TCM has been widely used in China. To evaluate the efficacy of TCM prescription combined with low-molecular-weight heparin (LMWH) for preventing DVT after major orthopedics surgery. All the retrieved articles were evaluated using specific inclusion and exclusion criteria. Then, data were extracted and evaluated for inclusion in a randomized controlled trial. In this study, variables included relative risk (RR), mean difference (MD), and their corresponding 95% confidence intervals (95% CIs). Overall, 16 articles were included with 1538 patients, 768 in the combination group (combination of TCM prescription and LMWH) and 770 in the LMWH group. The results indicated that in the combination group, the incidence of DVT (RR: 0.34, 95% CI: 0.23-0.50, P < .00001) and d-dimer levels (standardized mean difference: −1.19, 95% CI: −1.80 to −0.58, P = .0001) was significantly lower than that in the LMWH group. Furthermore, the combination treatment obviously decreased the concentration of fibrinogen (MD: −1.19, 95% CI: −2.13 to −0.25, P = .01). The combination of TCM prescription and LMWH could significantly reduce the incidence of DVT, suggesting that it may be a more effective prophylaxis measure for DVT after major orthopedics surgery.


BMJ ◽  
1982 ◽  
Vol 284 (6313) ◽  
pp. 375-379 ◽  
Author(s):  
V V Kakkar ◽  
B Djazaeri ◽  
J Fok ◽  
M Fletcher ◽  
M F Scully ◽  
...  

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